[The comparison of predicting clinical outcomes between immunolophenotype and hematological complete remission before human leukocyte antigen-matched sibling donor transplantation in acute myeloid leukemia].

To assess the prognostic significance of immunophenotype complete remission (ICR) and hematological complete remission (HCR) before human-leukocyte antigen (HLA)-matched sibling donor transplantation (MSDT) in acute myeloid leukemia (AML) patients. A cohort of 182 AML (non-APL) patients undergoing MSDT in HCR was retrospectively studied [including complete remission with ANC and PLT recovery (CR), CR with incomplete PLT recovery (CRp), CR with inconplete ANC and PLT recovery (CRi)]; ICR was determined as undetective minimal resudial disease (MRD) by multi-parameter flow cytometer. ①Of the 182 patients, 97 were male, 85 female, and the median age was 41(4-62) years. ②The CR and CRi+CRp rates were 80.8% (147/182) and 19.2%(35/182), respectively; The 4-year cumulative incidence of relapse[CIR, (11.0±4.3)% (16.0±7.1)%, (2)=0.274, =0.600], non-relapse mortality[NRM, (14.0±4.3)% (9.0±6.3)%, (2)=0.913, =0.339], leukemia-free survival[LFS, (75.0±5.1)% (75.0±8.3)%, (2)=0.256, =0.613], and overall survial [OS, (77.0±5.2)% (80.0±8.1)%, (2)=0.140, =0.708] were comparable between the CRp+CRi and CR groups. ③Compared with the non-ICR group (=35), the ICR group (=147) showed lower 4-year CIR [(11.3±3.4) % (55.2±8.8) %, (2)=32.687, <0.001], better 4-year LFS [(76.2±4.7)% (32.8±8.7)%, (2)=26.234, <0.001] and OS[(79.0±4.7)% (39.0±9.1)%, (2)=25.253, <0.001], and comparable NRM[(12.5±4.1)% (12.0±7.1)%, (2)=1.002, =0.656]. ④Mulitvariate analysis confirmed the independent prognostic value of ICR in lower CIR [=11.026(95% 4.685-25.949), <0.001], higher LFS [=5.785 (95% 2.974-11.254), <0.001] and OS[=5.578 (95% 2.575-27.565), <0.001]. The results indicated that ICR instead of HCR pre-transplantation had a significant prognostic value in AML patients undergoing MSDT.